Topics Related to Medicaid Managed Care
Reminders for NC Medicaid Managed Care, NC Medicaid Direct and Medicare.
Effective July 24, 2026, Basaglar® U-100 KwikPen® moved to Preferred status due to reported shortage of Lantus SoloStar pen.
The revised NC Medicaid 1915(i) assessment must be used starting Oct. 1, 2026, and includes a new companion guide.
This bulletin replaces in full the December 2025 Utilization Management by Managed Care Plans Aligned with Food and Drug Administration Labeling bulletin.
NC Medicaid, in collaboration with the four NC Medicaid Managed Care Standard Plans, will host the Sixth Annual Virtual Statewide Quality Forum on Wednesday, Oct. 14, 2026, from 11 a.m. to 1 p.m.
Amendments to Clinical Coverage Policy 1A-20, expanding medical necessity criteria and updating coverage for sleep studies and polysomnography services are effective July 1, 2026.
Care Management rate considerations effective July 1, 2026.
Impacted NC Medicaid providers will be included in the Active Provider Reverification Report, and notifications with specific deadlines are expected by the end of September 2026.
The deadlines stated in this bulletin replace those previously published in the Post-Enrollment National Accreditation Update bulletin April 16, 2026.
Adverse determination letters generated through NCTracks have been updated to reflect these changes.